ca.infoway.messagebuilder.model.pcs_mr2007_v02_r02.claims.merged
Class AdjudicatedResultsGroupBean

java.lang.Object
  ca.infoway.messagebuilder.model.MessagePartBean
      ca.infoway.messagebuilder.model.pcs_mr2007_v02_r02.claims.merged.AdjudicatedResultsGroupBean

All Implemented Interfaces:

NullFlavorSupport, Serializable

public class AdjudicatedResultsGroupBean
extends MessagePartBean

Business Name: AdjudicatedResultsGroup

QUCR_MT810201CA.AdjudResultsGroup: Adjudicated Results Group

The AdjudResultsGroup.netAmt must equal the sum of all immediate children AdjudResultsGroup.netAmt

Associations to the right are used for breaking down

a Payment Advice (e.g. provider, sending appl) or

a Statement of Financial Activity (e.g. payee, payor).

Only 1 association can be specified per instance of this act.

FICR_MT610201CA.AdjudResultsGroup: Adjudicated Results Group

A collection of results for invoice elements adjudicated as a group.

FICR_MT630000CA.AdjudResultsGroup: Adjudicated Results Group

Payor must be specified for the root Act ONLY. Payee is optional, but may only be specified for the root Act.

Group of results for line items/invoice elements previously adjudicated.

See Also:

Serialized Form

Constructor Summary

AdjudicatedResultsGroupBean()

Method Summary

CarrierOrThirdPartyAdministratorBean	getAuthorAdjudResultsCarrierRole() Un-merged Business Name: (no business name specified)
ActInvoiceAdjudicationPaymentCode	getCode() Un-merged Business Name: TypeOfSummary
List<AdjudicatedResultsGroupBean>	getComponentAdjudResultsGroup() Un-merged Business Name: (no business name specified)
PayeeAccountBean	getCreditAccount() Un-merged Business Name: (no business name specified)
AccountBean	getDebitAccount() Un-merged Business Name: (no business name specified)
DevicePlayingTheSendingApplicationRoleBean	getDeviceAdjudResultsSendingAppRole() Un-merged Business Name: (no business name specified)
Interval<Date>	getEffectiveTime() Un-merged Business Name: TimePeriodForThePayment
Identifier	getId() Business Name: AdjudicatedResultsGroupID
ServiceLocationBean	getLocationServiceDeliveryLocation() Un-merged Business Name: (no business name specified)
Money	getNetAmt() Un-merged Business Name: SummaryPeriodAmt
ProviderIDBean	getPerformerAdjudResultsProviderRole() Un-merged Business Name: (no business name specified)
BusinessArrangementBean	getReferenceAdjudResultsFinancialContract() Un-merged Business Name: (no business name specified)
List<SummaryDetailsBean>	getSummaryAdjudResultsGroupSummaryData() Un-merged Business Name: (no business name specified)
void	setAuthorAdjudResultsCarrierRole(CarrierOrThirdPartyAdministratorBean authorAdjudResultsCarrierRole) Un-merged Business Name: (no business name specified)
void	setCode(ActInvoiceAdjudicationPaymentCode code) Un-merged Business Name: TypeOfSummary
void	setCreditAccount(PayeeAccountBean creditAccount) Un-merged Business Name: (no business name specified)
void	setDebitAccount(AccountBean debitAccount) Un-merged Business Name: (no business name specified)
void	setDeviceAdjudResultsSendingAppRole(DevicePlayingTheSendingApplicationRoleBean deviceAdjudResultsSendingAppRole) Un-merged Business Name: (no business name specified)
void	setEffectiveTime(Interval<Date> effectiveTime) Un-merged Business Name: TimePeriodForThePayment
void	setId(Identifier id) Business Name: AdjudicatedResultsGroupID
void	setLocationServiceDeliveryLocation(ServiceLocationBean locationServiceDeliveryLocation) Un-merged Business Name: (no business name specified)
void	setNetAmt(Money netAmt) Un-merged Business Name: SummaryPeriodAmt
void	setPerformerAdjudResultsProviderRole(ProviderIDBean performerAdjudResultsProviderRole) Un-merged Business Name: (no business name specified)
void	setReferenceAdjudResultsFinancialContract(BusinessArrangementBean referenceAdjudResultsFinancialContract) Un-merged Business Name: (no business name specified)

Methods inherited from class ca.infoway.messagebuilder.model.MessagePartBean

getField, getNullFlavor, getNullFlavor, getSpecializationType, hasNullFlavor, hasNullFlavor, setNullFlavor, setNullFlavor, setSpecializationType

Methods inherited from class java.lang.Object

clone, equals, finalize, getClass, hashCode, notify, notifyAll, toString, wait, wait, wait

Constructor Detail

AdjudicatedResultsGroupBean

public AdjudicatedResultsGroupBean()

Method Detail

getId

public Identifier getId()

Business Name: AdjudicatedResultsGroupID

Un-merged Business Name: AdjudicatedResultsGroupID

Relationship: QUCR_MT810201CA.AdjudResultsGroup.id

Conformance/Cardinality: POPULATED (1)

If specified on a Payment Advice Summary, can be used to request additional detail with a Payment Advice Query message

(If specified on a Payment Advice Summary, can be used to request additional detail with a Payment Advice Query message

ID of Results Group

Un-merged Business Name: AdjudicatedResultsGroupID

Relationship: FICR_MT610201CA.AdjudResultsGroup.id

Conformance/Cardinality: POPULATED (1)

For Payment Advice Summary: can be used to request additional detail with a Payment Advice Query message.

For Payment Advice Summary: can be used to request additional detail with a Payment Advice Query message.

Id of adjudicated Results Group

setId

public void setId(Identifier id)

Business Name: AdjudicatedResultsGroupID

Un-merged Business Name: AdjudicatedResultsGroupID

Relationship: QUCR_MT810201CA.AdjudResultsGroup.id

Conformance/Cardinality: POPULATED (1)

If specified on a Payment Advice Summary, can be used to request additional detail with a Payment Advice Query message

(If specified on a Payment Advice Summary, can be used to request additional detail with a Payment Advice Query message

ID of Results Group

Un-merged Business Name: AdjudicatedResultsGroupID

Relationship: FICR_MT610201CA.AdjudResultsGroup.id

Conformance/Cardinality: POPULATED (1)

For Payment Advice Summary: can be used to request additional detail with a Payment Advice Query message.

For Payment Advice Summary: can be used to request additional detail with a Payment Advice Query message.

Id of adjudicated Results Group

getCode

public ActInvoiceAdjudicationPaymentCode getCode()

Un-merged Business Name: TypeOfSummary

Relationship: QUCR_MT810201CA.AdjudResultsGroup.code

Conformance/Cardinality: MANDATORY (1)

This code describes the breakdown of the financial activity.

-For Payment Advice: For Vision Care payment advices, RETRO adjustments will always include references to the EOBs that made up the retroactive adjustment.

For Payment Advice: For Pharmacy payment advices, RETRO adjustments will not include references to the EOBs that made up the retroactive adjustment. Providers must submit a Payment Advice Query message to get the EOBs referenced by the RETRO amount. The Payment Advice Detail message, however, is not currently supported in Pharmacy.

For Payment Advice: Code also specifies the type of adjustment for a payment advice (e.g. CFWD - carry forward adjustment).

Type of summary

Un-merged Business Name: TypeOfSummary

Relationship: FICR_MT610201CA.AdjudResultsGroup.code

Conformance/Cardinality: MANDATORY (1)

This code describes the breakdown of the financial activity.

For Payment Advice: For Vision Care payment advices, RETRO adjustments will always include references to the EOBs that made up the retroactive adjustment.

For Payment Advice: For Pharmacy payment advices, RETRO adjustments will not include references to the EOBs that made up the retroactive adjustment. Providers must submit a Payment Advice Query message to get the EOBs referenced by the RETRO amount. The Payment Advice Detail message, however, is not currently supported in Pharmacy.

For Payment Advice: Code also specifies the type of adjustment for a payment advice (e.g. CFWD - carry forward adjustment).

Un-merged Business Name: BreakdownOfFinancialActivity

Relationship: FICR_MT630000CA.AdjudResultsGroup.code

Conformance/Cardinality: MANDATORY (1)

For Payment Advice: For Vision Care payment advices, RETRO adjustments will always include references to the EOBs that made up the retroactive adjustment.

For Payment Advice: For Pharmacy payment advices, RETRO adjustments will not include references to the EOBs that made up the retroactive adjustment. Providers must submit a Payment Advice Query message to get the EOBs referenced by the RETRO amount. The Payment Advice Detail message, however, is not currently supported in Pharmacy.

For Payment Advice: Code also specifies the type of adjustment for a payment advice (e.g. CFWD - carry forward adjustment).

This code describes the breakdown of the financial activity and defines the 'categorization; Only really relevant for summaries.

setCode

public void setCode(ActInvoiceAdjudicationPaymentCode code)

Un-merged Business Name: TypeOfSummary

Relationship: QUCR_MT810201CA.AdjudResultsGroup.code

Conformance/Cardinality: MANDATORY (1)

This code describes the breakdown of the financial activity.

-For Payment Advice: For Vision Care payment advices, RETRO adjustments will always include references to the EOBs that made up the retroactive adjustment.

For Payment Advice: For Pharmacy payment advices, RETRO adjustments will not include references to the EOBs that made up the retroactive adjustment. Providers must submit a Payment Advice Query message to get the EOBs referenced by the RETRO amount. The Payment Advice Detail message, however, is not currently supported in Pharmacy.

For Payment Advice: Code also specifies the type of adjustment for a payment advice (e.g. CFWD - carry forward adjustment).

Type of summary

Un-merged Business Name: TypeOfSummary

Relationship: FICR_MT610201CA.AdjudResultsGroup.code

Conformance/Cardinality: MANDATORY (1)

This code describes the breakdown of the financial activity.

For Payment Advice: For Vision Care payment advices, RETRO adjustments will always include references to the EOBs that made up the retroactive adjustment.

For Payment Advice: For Pharmacy payment advices, RETRO adjustments will not include references to the EOBs that made up the retroactive adjustment. Providers must submit a Payment Advice Query message to get the EOBs referenced by the RETRO amount. The Payment Advice Detail message, however, is not currently supported in Pharmacy.

For Payment Advice: Code also specifies the type of adjustment for a payment advice (e.g. CFWD - carry forward adjustment).

Un-merged Business Name: BreakdownOfFinancialActivity

Relationship: FICR_MT630000CA.AdjudResultsGroup.code

Conformance/Cardinality: MANDATORY (1)

For Payment Advice: For Vision Care payment advices, RETRO adjustments will always include references to the EOBs that made up the retroactive adjustment.

For Payment Advice: For Pharmacy payment advices, RETRO adjustments will not include references to the EOBs that made up the retroactive adjustment. Providers must submit a Payment Advice Query message to get the EOBs referenced by the RETRO amount. The Payment Advice Detail message, however, is not currently supported in Pharmacy.

For Payment Advice: Code also specifies the type of adjustment for a payment advice (e.g. CFWD - carry forward adjustment).

This code describes the breakdown of the financial activity and defines the 'categorization; Only really relevant for summaries.

getEffectiveTime

public Interval<Date> getEffectiveTime()

Un-merged Business Name: TimePeriodForThePayment

Relationship: QUCR_MT810201CA.AdjudResultsGroup.effectiveTime

Conformance/Cardinality: POPULATED (1)

Time period for the payment or summary period.

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Un-merged Business Name: SummaryPeriodDateRange

Relationship: FICR_MT610201CA.AdjudResultsGroup.effectiveTime

Conformance/Cardinality: POPULATED (1)

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Time period for the payment or summary period.

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Un-merged Business Name: TimePeriodForThePayment

Relationship: FICR_MT630000CA.AdjudResultsGroup.effectiveTime

Conformance/Cardinality: POPULATED (1)

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Time period for the payment or summary period.

setEffectiveTime

public void setEffectiveTime(Interval<Date> effectiveTime)

Un-merged Business Name: TimePeriodForThePayment

Relationship: QUCR_MT810201CA.AdjudResultsGroup.effectiveTime

Conformance/Cardinality: POPULATED (1)

Time period for the payment or summary period.

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Un-merged Business Name: SummaryPeriodDateRange

Relationship: FICR_MT610201CA.AdjudResultsGroup.effectiveTime

Conformance/Cardinality: POPULATED (1)

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Time period for the payment or summary period.

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Un-merged Business Name: TimePeriodForThePayment

Relationship: FICR_MT630000CA.AdjudResultsGroup.effectiveTime

Conformance/Cardinality: POPULATED (1)

For Payment Advice: Can also indicate time period over which the clawback and/or retro adjustment applies.

Time period for the payment or summary period.

getNetAmt

public Money getNetAmt()

Un-merged Business Name: SummaryPeriodAmt

Relationship: QUCR_MT810201CA.AdjudResultsGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

Can also indicate time period over which the clawback and/or retro adjustment applies

On SOFA Summary, this could be used to specify the amount that will be included in the Payment Advice. In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

Summary Period Amt

Un-merged Business Name: SummaryPeriodAmount

Relationship: FICR_MT610201CA.AdjudResultsGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

On SOFA Summary, this could be used to specify the amount that will be included in the Payment Advice. In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

Grand total of all SOFA observations contained in this summary - Daily Total

Un-merged Business Name: SummaryPeriodAmt

Relationship: FICR_MT630000CA.AdjudResultsGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

On SOFA Summary, this could be used to specify the amount that will be included in the Payment Advice. In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

Summary Period Amt - Grand total of all SOFA observations contained in this summary

setNetAmt

public void setNetAmt(Money netAmt)

Un-merged Business Name: SummaryPeriodAmt

Relationship: QUCR_MT810201CA.AdjudResultsGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

Can also indicate time period over which the clawback and/or retro adjustment applies

On SOFA Summary, this could be used to specify the amount that will be included in the Payment Advice. In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

Summary Period Amt

Un-merged Business Name: SummaryPeriodAmount

Relationship: FICR_MT610201CA.AdjudResultsGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

On SOFA Summary, this could be used to specify the amount that will be included in the Payment Advice. In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

Grand total of all SOFA observations contained in this summary - Daily Total

Un-merged Business Name: SummaryPeriodAmt

Relationship: FICR_MT630000CA.AdjudResultsGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

On SOFA Summary, this could be used to specify the amount that will be included in the Payment Advice. In this situation, it should equal the net effect of all AdjudResultsGroupSummaryData elements that would appear in the Payment Advice.

Summary Period Amt - Grand total of all SOFA observations contained in this summary

getDeviceAdjudResultsSendingAppRole

public DevicePlayingTheSendingApplicationRoleBean getDeviceAdjudResultsSendingAppRole()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.Device.adjudResultsSendingAppRole

Conformance/Cardinality: POPULATED (1)

setDeviceAdjudResultsSendingAppRole

public void setDeviceAdjudResultsSendingAppRole(DevicePlayingTheSendingApplicationRoleBean deviceAdjudResultsSendingAppRole)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.Device.adjudResultsSendingAppRole

Conformance/Cardinality: POPULATED (1)

getPerformerAdjudResultsProviderRole

public ProviderIDBean getPerformerAdjudResultsProviderRole()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.Performer.adjudResultsProviderRole

Conformance/Cardinality: POPULATED (1)

setPerformerAdjudResultsProviderRole

public void setPerformerAdjudResultsProviderRole(ProviderIDBean performerAdjudResultsProviderRole)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.Performer.adjudResultsProviderRole

Conformance/Cardinality: POPULATED (1)

getAuthorAdjudResultsCarrierRole

public CarrierOrThirdPartyAdministratorBean getAuthorAdjudResultsCarrierRole()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.Author.adjudResultsCarrierRole

Conformance/Cardinality: POPULATED (1)

setAuthorAdjudResultsCarrierRole

public void setAuthorAdjudResultsCarrierRole(CarrierOrThirdPartyAdministratorBean authorAdjudResultsCarrierRole)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.Author.adjudResultsCarrierRole

Conformance/Cardinality: POPULATED (1)

getLocationServiceDeliveryLocation

public ServiceLocationBean getLocationServiceDeliveryLocation()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupLocation.serviceDeliveryLocation

Conformance/Cardinality: POPULATED (1)

setLocationServiceDeliveryLocation

public void setLocationServiceDeliveryLocation(ServiceLocationBean locationServiceDeliveryLocation)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupLocation.serviceDeliveryLocation

Conformance/Cardinality: POPULATED (1)

getReferenceAdjudResultsFinancialContract

public BusinessArrangementBean getReferenceAdjudResultsFinancialContract()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupRef.adjudResultsFinancialContract

Conformance/Cardinality: POPULATED (1)

setReferenceAdjudResultsFinancialContract

public void setReferenceAdjudResultsFinancialContract(BusinessArrangementBean referenceAdjudResultsFinancialContract)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupRef.adjudResultsFinancialContract

Conformance/Cardinality: POPULATED (1)

getSummaryAdjudResultsGroupSummaryData

public List<SummaryDetailsBean> getSummaryAdjudResultsGroupSummaryData()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupSummary.adjudResultsGroupSummaryData

Conformance/Cardinality: POPULATED (1)

Un-merged Business Name: (no business name specified)

Relationship: FICR_MT610201CA.AdjudResultsGroupSummary.adjudResultsGroupSummaryData

Conformance/Cardinality: POPULATED (1)

Un-merged Business Name: (no business name specified)

Relationship: FICR_MT630000CA.AdjudResultsGroupSummary.adjudResultsGroupSummaryData

Conformance/Cardinality: POPULATED (1)

getCreditAccount

public PayeeAccountBean getCreditAccount()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupPayee.account

Conformance/Cardinality: POPULATED (1)

setCreditAccount

public void setCreditAccount(PayeeAccountBean creditAccount)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupPayee.account

Conformance/Cardinality: POPULATED (1)

getDebitAccount

public AccountBean getDebitAccount()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupPayor.account

Conformance/Cardinality: POPULATED (1)

setDebitAccount

public void setDebitAccount(AccountBean debitAccount)

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupPayor.account

Conformance/Cardinality: POPULATED (1)

getComponentAdjudResultsGroup

public List<AdjudicatedResultsGroupBean> getComponentAdjudResultsGroup()

Un-merged Business Name: (no business name specified)

Relationship: QUCR_MT810201CA.AdjudResultsGroupComponent.adjudResultsGroup

Conformance/Cardinality: POPULATED (1)